Myeloid Tissue Histology | Micro HSB A
1st Year – 1st Semester – Midterms – 2nd Week (Bravo, M.D.)
Lecture outline (a checklist)
✓ Review of bone & bone marrow histology
✓ Erythropoiesis & cells involved
✓ Granulopoiesis & cells involved
✓ Thrombopoiesis & cells involved
✓ Clinical correlation
Function of the bone
▪ Musculoskeletal system – serves as attachment points for tendons
▪ Support – provides protection & support for soft tissues and organs
▪ Locomotion – assists in movement
▪ Storage – mineral (calcium & phosphate) reservoir which can be released
when needed by the body
▪ Hematopoiesis – allows for red blood cell production
o Red marrow – actively produces RBCs, WBCs, and PLTs
o Yellow marrow – allows for TAG storage as fat droplets
Bone marrow histology
▪ Composition – network of marrow sinuses & capillaries
o Note: Both red & yellow marrow are highly-vascular with sinuses
▪ Predominant cells – dictates what type of marrow is present
o Red marrow – active hematopoietic stem cells
o Yellow marrow – adipose cells
o Composition – highly-infiltrated with fat
o Location – shaft of long bones of adults
o Function – storage of triglycerides
o Note: Not hematopoietic but can potentially be activated when needed
o Composition – highly-vascular with large venous sinusoids and many
islands of hematopoietic cells
o Location – flat, irregular, short, and epiphyses of long bones
o Amount of red marrow – varies with the age of patient
▪ Childhood – 100% red bone marrow present in virtually every bone
▪ Adults – ~50% red bone marrow present in ribs, skull, sternum,
vertebrae and pelvis (RSVP)
▪ Elders (~70 y/o) – ~30% red bone marrow
Hematopoiesis
▪ Pluripotent/multipotent stem cell – common precursor all cells in the blood
o Two cell types derived from this stem cell:
▪ Common myeloid precursor – gives rise to RBCs, PLTs, WBCs
(except for lymphocyte)
▪ Common lymphoid precursor – gives rise to lymphocytes
Erythropoiesis
▪ Erythropoietic stem cells – have distinguishing characteristics
o Cytoplasm – granules are absent
o Nucleus – round
▪ Three parameters to distinguish maturation:
o Size – cells become smaller
o Staining – cells become more eosinophilic
o Nucleus – nucleus becomes condenses & eventually disappears
▪ Five stages of maturation:
o Proerythroblast (1st identifiable RBC precursor)
▪ Characteristic – nucleolus is present (RNA is being produced)
▪ Size – largest in the series
▪ Cytoplasm – basophilic
o Basophilic erythroblast
▪ Characteristic – nucleolus is absent (basophilic due to ribosomes)
• Note: Cell appears very blue due to accumulation of abundant
RNA & ribosomes
▪ Size – smaller than before
▪ Cytoplasm – intensely basophilic
o Polychromatic erythroblast
▪ Characteristic – nucleus is condensed & checkerboard
▪ Size – smaller than before
▪ Cytoplasm – gray-green due to hemoglobin accumulation
o Orthochromatic erythroblast
▪ AKA. normoblast (due to being similar color as normal RBCs)
▪ Characteristic – nucleus is completely-condensed (pyknotic)
• Note: Eventually the nucleus is extruded at this stage
▪ Size – smaller than before
▪ Cytoplasm – pink due to high-levels of hemoglobin
o Reticulocytes
▪ Characteristic – nucleus is absent with network-type pattern due to
ribosomes
• Note: Youngest erythrocytes released into circulation
▪ Size – smaller than before
▪ Cytoplasm – pink (similar to RBCs)
▪ Disintegration of ribosomes → mature RBCs
▪ Significance – very good indicator of bone marrow health
• High amount – severe loss of mature RBCs
• Low amount – aplastic anemia (bone marrow depression)
▪ Summary of erythropoiesis:
o Size – large → small
o Nucleus – diffuse → condensed → extruded
o Staining – blue (basophilic) → red (eosinophilic)
Granulopoiesis
▪ Note: Neutrophilic lineage will be focused on since the development of
eosinophils & basophils follow a similar pattern
▪ Granulopoietic stem cells – have distinguishing characteristics
o Cytoplasm – granules are present
o Nucleus – shape-change is present
▪ Two parameters to distinguish maturation:
o Granules – characteristic type of granule per stage of maturity
o Nucleus – characteristic shape of nucleus per stage of maturity
▪ Four stages of maturation:
o Promyelocyte (1st identifiable neutrophilic precursor)
▪ Characteristic – contain only purple-staining azurophilic non-specific
granules in the cytoplasm
• Note: Non-specific granules are present in other cell lineages
▪ Size – largest in the series
▪ Nucleus – contains nucleoli
o Myelocyte
▪ Characteristic – contain both purple-staining azurophilic non-
specific & lilac-staining specific granules
▪ Size – varies & considered to have the widest range in cell size
▪ Nucleus – frequently indented
 o Metamyelocyte
▪ Characteristic – contain only lilac-staining specific granules
▪ Size – smaller than before
▪ Nucleus – flattened in shape
o Band cell
▪ Characteristic – nucleus is horse-shoe shaped
o Neutrophil
▪ Characteristic – nucleus is segmented into lobes
Thrombopoiesis
▪ Two stages of maturation:
o Megakaryoblast (1st identifiable thrombopoietic precursor)
▪ Characteristic – granules are absent
▪ Presence – rarely-seen
▪ Size – larger than before
▪ Nucleus – large & lobed
o Megakaryocyte
▪ Characteristic – granules are present
▪ Size – extremely large
▪ Location – near the sinusoids
▪ Polypoid – undergo endomitosis (nuclear division without
cytoplasmic division)
▪ Function – fragments into platelets
• Platelet budding – due to formation of proplatelet pseudopods
o Note: Platelets are directly-released into platelets
Clinical correlation
▪ Acute myelogenous leukemia
o Characteristic – bone marrow picture shows almost all cells are myeloid
progenitors
o Symptoms of AML:
▪ Infection – immature WBCs can not fight off microorganisms
▪ Bleeding – megakaryocytes are replaced with myeloid progenitors

Whenever a doctor cannot do good, he must be kept from doing harm.

Hippocrates

AngeloBautista